Surgical Prophylaxis - Urological Surgery

 

Transurethral resection of bladder tumours

Antibiotic prophylaxis is not recommended

 

Transrectal prostate biopsy (urological or radiological)

Where surgery is elective it is essential to send a specimen of urine prior to the procedure with a view to modifying the choice of antibiotic if resistance to the prophylactic agent is detected.

CIPROFLOXACIN 750mg bd po

plus

METRONIDAZOLE 400mg tds po

 

OR

 

OFLOXACIN 400mg od po

plus

METRONIDAZOLE 400mg tds po

 

}

 


 

 

}

 

Single dose starting at least 1 to 2 hours before procedure if less than 5 biopsies; or up to a total of 3 days if multiple biopsies

 

 

 

Single dose starting at least 1 to 2 hours before procedure if less than 5 biopsies; or up to a total of 3 days if multiple biopsies 

 

All other urological procedures

Where surgery is elective it is essential to send a specimen of urine prior to the procedure with a view to modifying the choice of antibiotic if resistance to the prophylactic agent is detected.

GENTAMICIN 3mg/kg (maximum  dose 300mg)

 (dose table for Ideal Body Weight)

If CrCl <21 maximum  dose 180mg

plus

AMOXICILLIN 1g  (NB: for patients >90kg give 1.5g)

If anaerobic cover is required (eg. GI manipulation) then:

ADD

METRONIDAZOLE 500mg

}

 

IV single dose only at induction

  

If current / previous MRSA positive:

OR

If penicillin allergy (explanatory notes) use:

 

 

 GENTAMICIN 3mg/kg (maximum dose 300mg)

(dose table for Ideal Body Weight)

If CrCl <21 maximum dose 180mg)  

plus

TEICOPLANIN
Dose:
<50kg: 600mg
50-74kg: 800mg
75-100kg: 1000mg
>100kg: 1200mg

If anaerobic cover is required (eg. GI manipulation) then:

ADD

METRONIDAZOLE 500mg

}

 

IV single dose only at induction

 

Antibiotic prophylaxis MAY NOT be indicated for uncomplicated cystoscopy where urine is sterile and there is no previous history of urinary tract infection.

 

Last reviewed: 15/11/17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last reviewed: 20/09/17

For guidance on the administration of intravenous antibiotics click here
(GHNHSFT intranet)